Pōpoki i ālai ʻia (Ke ālai ʻia ʻo Feline Urethral Obstruction) a me ka maʻi maʻi wāwae hope¶

I loko o ka lāʻau lapaʻau lāʻau lapaʻau lāʻau, ʻekolu mau pilikia koʻikoʻi o ke kino haʻahaʻa e hoʻopili pinepine ʻia i ka huikau o ka mea nona ka mea e koi koke i ka hana e pale aku i ka hopu ʻana o ka naʻau a i ʻole ka paraplegia mau loa: Feline Urethral Obstruction (ka "Blocked Cat"), Feline Aortic Thromboembolism (FATE, a i ʻole "Saddle Thrombus" maʻi ʻokoʻa a i ʻole ka maʻi ʻokoʻa o ka maʻi maʻi (DD) Disc" hoʻoemi kuamoʻo). Ke kuhi hewa pinepine nei ka poe nona ka pipi i ka popoki kane e uē ana i loko o ka pahu litter no ka paopao pono ole, a i ole ia, ua haule ka popoki e kauo ana i kona mau wawae hope mai ke kuapo a hili ka puhaka. I loko o 12 a 36 mau hola, ʻo ke keakea ʻana i ka urethral i hoʻopaʻa ʻole ʻia ke kumu o ka make ʻana o ka potassium poisoning o ka ʻiʻo o ka puʻuwai, aʻo ka hoʻokuʻu ʻia ʻana o ka spinal disc me ka nalo ʻana o ka ʻeha hohonu e ʻoki mau ai i nā ala kaʻa haʻahaʻa. ʻO ka hoʻokaʻawale ʻana ma waena o ka ʻōpū i hoʻopaʻa ʻia i ka pōhaku, nā wāwae hope ʻole puʻupuʻu mai kahi koko koko, a me kahi iwi ʻeha ʻeha e hiki ai iā ʻoe ke hoʻopaʻa i kāu pipi me ka palekana a hiki i kahi haukapila ulia pōpilikia 24-hola ʻoiai ke ola a me ka hoʻōla neurological hiki ke hiki.

E hana i kēia i kēia manawa¶

1. E pale iā ʻoe iho mai ka ʻeha ʻeha ma mua o ka hoʻopā ʻana i ka pipi leo a i ʻole ka holoholona lolo. Hiki i ka pōpoki mālie a i ʻole ka ʻīlio ke nahu hohonu i ka wā e makaʻu ʻia ai e ka ʻōpū koko ischemic, ka ʻāʻī ʻāʻī o ke kuamoʻo, a i ʻole ka ʻōpū ʻāʻī. Inā nahu loa ke kanaka (ʻoi aku ka nahu ʻana o ka pōpoki i ka lima a i ʻole ka pulima lima), e kelepona i ka wahi helu pilikia (911 ma ʻAmelika Hui Pū ʻIa a me Kanada, 112 ma waena o ka Hui ʻEulopa, 999 ma United Kingdom, 000 ma Australia) a i ʻole e ʻimi i ka mālama olakino wikiwiki. Ma mua o ka hāpai ʻana i ka pōpoki ʻeha, e kau i kahi kāwele ʻauʻau mānoanoa ma luna o ko lākou poʻo a me ka ʻōpū; no ka ʻīlio ʻeha ʻaʻole ** luaʻi, ʻuhū nui, a i ʻole maka palahalaha, e hoʻopili i kahi kāwele palupalu a puni ka ihu i ka wā e hāpai wale ana.
2. NO KA PAPA KANE E AIA AI I KA PAHU LAPA ME KA ZERO URINE: E hele koke i ka 24-hour ER vet. Ina kau popoki (o ka popoki kane paha) e kulou mau ana iloko a mawaho paha o ka pahu, uwo, lick mau i kona peni, a hana mai i ka mimi zero a i ole he kulu wai wale no a hiki i kakahiaka, **. Ua hoʻopaʻa ʻia kahi puʻupuʻu o nā kristal microscopic a me ka mucus i kāna urethra penile haiki. Mai kaomi a ʻomi paha i ka ʻōpū o ka pōpoki, no ka mea, e naha ana ka ʻōpū o ka ʻōpū i piha i ka ʻōpū.
3. NO KA PIPIKI E HAHA EWEHE AE ANA A KAUO I NA WAEWA HUI ELUA: E nana i ka wawae hope no ka mahana a me ka waihooluu. Ina e puka koke mai kou popoki i ka iuo hou, haule ma kona aoao, hamama ka waha, a kauo i kekahi a elua paha mau wawae hope i ma'i. Inā ʻike nā wāwae hope i ka ** hau-anu ** a ʻike ʻia ka ʻaoʻao wāwae a i ʻole nā ​​moena nail ** keʻokeʻo a i ʻole polū-ʻulaʻula **, ua ālai ke koko koko mai ka puʻuwai (Saddle Thrombus / FATE) i ke kahe koko i nā wāwae hope. E holo koke i ka haukapila lapaʻau 24-hola kokoke loa no ka hoʻomaha ʻana i ka ʻeha opioid intravenous.
4. NO KA Ilio WOBBLINES WAEWAHI HUA, KNUCKLING, A I OLE PARALYSIS: E hooikaika koke i ka hookui ana i ka pahu. Ina uwo kou ilio (o ka Dachshund, French Bulldog, Corgi, Beagle, Shih Tzu, Basset Hound, a me ke Kahuhipa Kelemania) ke uwo i kona kua, trembles. wāwae, kū ma ka piko o kona mau puʻupuʻu, a ʻaʻole hiki ke kū koke, ** hoʻōki i nā hele wāwae, nā alapiʻi, a me ka lele koke ʻana **. E hoʻopaʻa i ka ʻīlio ma kahi palahalaha a ʻoʻoleʻa (kahi pahu huakaʻi liʻiliʻi a i ʻole kahi papa ʻoʻoleʻa i uhi ʻia me ka pale) a lawe palahalaha i ke kaʻa.
5. ** MAI hāʻawi i nā lāʻau ʻeha kanaka (Ibuprofen, Naproxen, Tylenol/Paracetamol, a i ʻole Aspirin) i ka pōpoki a i ʻole ka ʻīlio. ʻO ka maʻa hoʻokahi o ka ibuprofen kanaka, naproxen, a i ʻole aspirin i loko o kahi ʻīlio e hoʻoulu ai i ka ʻeha ʻōpū nui a ** pale i ka neurosurgeon holoholona mai ka hāʻawi ʻana i nā steroid anti-inflammatory hoʻōla a i ʻole NSAID lāʻau holoholona** ma muli o nā paio holoi ʻana i ka lāʻau.
6. E kelepona i ka halemai ulia pōpilikia 24-hola ma ke kelepona ʻoiai e hoʻouka ana i ke kaʻa. E haʻi i ke kahu hānai hoʻāʻo i ke ʻano o kāu pipi, ke kaumaha, nā hōʻailona pololei, a me ka manawa hōʻea i manaʻo ʻia i hiki iā lākou ke hoʻomākaukau i kahi nānā ECG, hale oxygen, hoʻomaha ʻeha opioid, a i ʻole ka wehe ʻana i ka pahu catheter ma mua o kou hiki ʻana.

flowchart TD
    A["Pilikia Hikiwawe o ke Kino Haahaa i ka Poki a i ka Ilio"] --> B{"ʻO ke ʻano hōʻailona mua āu e ʻike ai?"}
    B -->|"ʻO ka pōkiʻi kuʻekuʻe pinepine i loko/waho o ka pahu litter, palu ʻana i nā ʻōpū, leo leo, hana 0 mimi."| C["FELINE URETHRAL OBSTRUCTION ('Piki Paʻa')"]
    B -->|"Uwe koke ka popoki i ka ʻeha, ʻaʻa ka waha, kauo i nā wāwae hope maʻi me ka ICE-COLD haikea/uliuli."| D["FELINE AORTIC THROMBOEMBOLISM ('Saddle Thrombus' Koko Koko)"]
    B -->|"Hōʻike ka ʻīlio a i ʻole ka popoki i ke kua i hope, e ʻona ana i nā wāwae hope, e kuʻi ana i nā wāwae, a i ʻole nā ​​wāwae hope maʻemaʻe."| E["KA HOʻOPIʻI IA ACUTE SPINAL CORD COMPRESSION (IVDD Slipped Disc / FCE / Trauma)"]
    C --> F["MAI kaomi i ka opu (e naha ka opu); e hoʻouka mālie i ka mea lawe; e holo wikiwiki i ka 24/7 ER Vet no ka ECG, ka hoʻohaʻahaʻa potassium a me ka wehe ʻana i ka catheter"]
    D --> G["E kāwele mālie i ke kāwele e pale ai i ka ʻeha ʻeha; Mai wela a lomilomi i nā wāwae; E holo wikiwiki i 24/7 ER Vet no ka IV methadone/fentanyl analgesia koke."]
    E --> H["Zero hele wāwae a i ʻole nā alapiʻi; e paheʻe ma luna o ka papa paʻa a i ʻole ka pahu liʻiliʻi; MAI haawi i na laau eha kanaka; E holo wikiwiki i ER Vet / Neurologist e hoʻāʻo i ka ʻeha hohonu"]

Mākēneki hoʻāʻo ʻokoʻa wikiwiki: Paʻa ʻia ʻo Cat vs.¶

E hoʻohana i kēia papa hoʻohālikelike lapaʻau e hoʻokaʻawale i waena o ka paʻa ʻana o ka mimi, ka constipation o ka ʻōpū, ka thrombosis arterial, a me ka ʻeha o ke kuamoʻo me ka hana ʻole ʻana i nā hana invasive e hiki ke hoʻonui i ka ʻeha.

Māhele 1: Luʻu hohonu: Feline Urethral Obstruction ("Blocked Cat")¶

ʻO ka Feline Lower Urinary Tract Disease (FLUTD) a me ka Feline Idiopathic Cystitis (FIC) e pili ana i nā miliona o nā pōpoki home. ʻOiai he urethra pōkole, ākea, hiki ke hoʻonui ʻia i nā pōpoki kane, ** ʻo nā pōpoki kāne (ʻo nā tomcats a me nā kāne neutered) he urethra lōʻihi ko S-like e hōʻemi ana i kahi puka pinhole liʻiliʻi 0.7-milimeter (0.028-ʻīniha) i loko o ka piko penile**.

No ke aha i pāpā ʻia ai nā pōpoki kāne: ʻO nā hana 3¶

1. Urethral Mucus a me Crystal Plugs (60 pākēneka o nā hihia): Ua hoʻokuʻu ʻia ke koʻikoʻi, ka mimi i hoʻopaʻa ʻia, a me nā protein inflammatory mai kahi pā o ka ʻōpū i hoʻonāukiuki ʻia me ka microscopic struvite (magnesium ammonium phosphate) a i ʻole ** calcium oxalate crystals** e hana i kahi paʻi e like me ka toothpaste e hoʻopili ʻia i loko o ka piko penile haiki.
2. Mineral Uroliths (Bladder Stones, 10 a 20 pakeneka o nā hihia): ʻO nā pōhaku mineral paʻa e ʻōwili i waho o ka ʻāʻī o ka ʻōpū a pili pono i loko o ka penis a i ʻole ka urethra pelvic.
3. Pono Urethral Spasm a me Edema (20 a 30 pakeneka o nā hihia): ʻOiai me ka ʻole o kahi plug paʻa, ʻo ka ʻeha neurogenic nui mai Feline Idiopathic Cystitis (hoʻoulu ʻia e ke kaumaha o ka hale, ka neʻe ʻana, ka walaʻau kūkulu, hakakā me kekahi pōpoki, a i ʻole nā ​​pahu lepo lepo) e hoʻopaʻa ʻia ka paia ʻiʻo o ka urethra i kahi spasm hiki ʻole ke haki.

ʻO ka papa manawa lapaʻau 4-pae o kahi pōpoki poloka (Hour 0 to Hour 48)¶

• Ka Papa 1, Māhele Hoʻomāinoino (Hora 0 a 8): Hele ka pōpoki i loko o ka pahu litter 5 a 15 mau manawa i ka hola, ʻeli me ka huhū, kuʻekuʻe me kona huelo paʻa paʻa, a hoʻokuʻu ʻia no 30 a 90 kekona i ka manawa. Hiki iā ia ke hāʻule i kahi kulu nui o ka mimi ʻulaʻula a i ʻole ke koko i ka wā mua, a laila hāʻule ʻole. He nui nā pōpoki ʻauʻau i loko o nā ʻauʻau ʻauʻau, ʻauʻau, a i ʻole nā ​​hīnaʻi holoi ʻoiai e palu ana i ko lākou mau ʻōpū.
• ** ʻĀpana 2, ʻEha Visceral a me ka Māhele Hoʻohaʻahaʻa (Hula 8 a hiki i 18):** Hoʻonui ʻia ka ʻōpū i hoʻopaʻa ʻia mai ka nui wōnati a hiki i ka nui o ka peach a i ʻole ka ʻalani. Uwo ka popoki, uwē, a uē paha me ka uē hohonu i ka wā e kuʻi ai a i ʻole e hoʻopā kekahi i kona ʻōpū, hele me ke kū ʻoʻoleʻa, peʻe i loko o nā keʻena pōʻeleʻele, a hōʻole i ka ʻai a me ka wai.
• ** Ka Papa 3, Uremic Toxicosis a me Bradycardia Phase (Hōlā 18 a hiki i 30):** Urea, creatinine, phosphorus, a me nā ʻakika metabolic e kahe ana i ke kahe koko ke pani ʻia ka kānana ʻana. Hoʻomaka ka popoki e luaʻi i ka huʻa keʻokeʻo, ka hua melemele, a i ʻole ka meaʻai, hoʻomohala i ka hanu like me ka ammonia ʻino, a ʻike i ka hāʻule ʻana o ka wela o ka rectal ma lalo o 37.5 degere Celsius (99.5 degere Fahrenheit) ʻoiai ke lohi nei kona puʻuwai ma lalo o 140 mau paʻi i kēlā me kēia minuke mai ka piʻi ʻana o ke koko potassium.
• Stage 4, Moribund Hyperkalemic Shock and Bladder Rupture (Hours 30 to 48): Moe palahalaha ka pōpoki ma kona ʻaoʻao, ʻaʻole i pane a comatose, me nā ʻāʻī hina hina a me ka puʻuwai o 80 a 110 paha i ka minuke. Inā pohā ka pā o ka ʻōpū necrotic i loko o ka ʻōpū, ua hoʻomaha iki paha ka pōpoki i ka ʻeha o ka ʻōpū no 1 a 2 mau hola oiai e kahe ana ka mimi ʻawaʻawa i ka ʻōpū o ka ʻōpū, a hahai koke ʻia e ka hopu ʻana i ka naʻau.

Pehea e nānā pono ai i kāu pōpoki ma ka home (a me ka mea ʻaʻole e hana)¶

• E nānā i ka moʻolelo o ka puʻupuʻu ʻōpala, ʻaʻole i ke ʻano o ke ʻano o ka pōpoki: ʻO ka ʻāʻī ʻana a me ka ʻāʻī ʻana o ka fecal ke ʻano like i loko o ka pahu litter. E hopu i ka litter scoop a nānā i ka pahu; inā ʻaʻohe ʻōpuʻu mimi pulu hou mai nā hola 8 a 12 i hala, e mālama i ka pōpoki me he mea lā ua paʻa.
• E nānā mālie i ka piko o ka penile: Inā ʻae ka pōpoki, e hāpai i ke kumu o ka huelo a nānā i lalo o ka anus. I loko o kahi tomcat i ālai ʻia, ʻo ka piko liʻiliʻi o ka penis e hoʻopili pinepine i ka 2 a i ka 4 millimeters (0.1 a 0.15 iniha) a nānā ʻia ka ʻulaʻula ʻeleʻele a i ʻole ka poni, i kekahi manawa me nā keʻokeʻo keʻokeʻo like me ke one.
• E nānā i ka piʻi ʻana o ka naʻau ma ka paia o ka umauma: ʻO kahi pōpoki maʻamau, kaumaha a ʻeha paha ka puʻuwai o 180 a 240 paha i kēlā me kēia minuke. E kau i kou lima ma ka umauma hema ma hope pono o ka kuʻe lima. Inā ʻoluʻolu kāu pōpoki e ʻaʻa nei me ka ka puʻuwai lohi ma lalo o 140 mau kuʻikuʻi i kēlā me kēia minuke, aia ka pōpoki i ka hyperkalemic cardiac toxicity a pono ka calcium gluconate i loko o ka ER holoholona i loko o nā minuke.
• ʻAʻole e ʻomi i ka ʻōpū a i ʻole ka ʻimi ʻana i ka penis ma ka home: Lilo ka ʻōpū manu keakea i ka pepa a palupalu i loko o nā hola; ʻo ka paʻi paʻa ʻana i ka ʻōpū e pohā ka paia o ka ʻōpū i loko o ka ʻōpū. Pēlā nō, mai hoʻokomo i kekahi mea i loko o ka penis o ka pōpoki, no ka mea, ʻoi aku ka liʻiliʻi o ka urethra feline ma ka pelvis a me ka maʻalahi o ka waimaka me ka hoʻomaha ʻole a me nā catheters sterile 3.5-French.

He aha ka hana ma ka 24-hour Emergency Vet (a me nā koho hoʻoholo kālā)¶

1. ** Hoʻopaʻa koke ʻia ka hoʻāʻo a me ka ECG: ** Hoʻokomo ka hui hoʻāʻo i kahi catheter IV, nānā i nā waiwai pālolo koko a me nā puʻupaʻa, a hoʻopili i kahi ECG. Inā kiʻekiʻe loa ka pāhare pāpaʻi, hoʻokomo ke kauka i 10 pākēneka Calcium Gluconate i loko o ke koko (pale i ka ʻiʻo o ka naʻau i loko o 60 kekona), a ukali ʻia e ** Insulin maʻamau me Dextrose** a me ka wai IV.
2. Analgesia and Decompressive Cystocentesis: Loaʻa i ka pōpoki ka lāʻau ʻeha opioid intravenous (buprenorphine, methadone, a i ʻole fentanyl) a me ka hoʻomaha.
3. Retrograde Urohydropropulsion ("Unblocking"): Me ka hoʻohana ʻana i ka catheter tomcat maʻemaʻe i wehe ʻia a me nā puʻupuʻu o ka paʻakai sterile, e hoʻokuʻu ke kauka holoholona i hope o ka piko mai ka piko o ka penile i loko o ka ʻōpū o ka ʻōpū, a laila hoʻopaʻa i kahi catheter mimi i loko no **24 a 72 mau hola i waho.
4. Inā ʻaʻole hiki iā ʻoe ke loaʻa i kahi hale hoʻokipa 3-lā: E ʻōlelo pololei i ka wā hoʻokolokolo. Hāʻawi ka nui o nā keʻena ulia pōpilikia i kahi "Outpatient Unblocking Protocol" kahi e hoʻomaha ai ke kauka lapaʻau i ka pōpoki, hoʻomaʻemaʻe i ka poloka, hoʻokahe i ka ʻōpū, hāʻawi i nā wai subcutaneous, buprenorphine e hōʻoluʻolu i ka ʻeha, a me prazosin a i ʻole tamsulosin nā mea hoʻomaha urethral, ​​a hoʻouna i ka pōpoki i ka home me ka ʻai ʻai pulu. ʻOiai ʻoi aku ka nui o 30 a 40 ka nui o ka pilikia o ka hoʻopaʻa ʻana i ka maʻi ma waho i ka hoʻohālikelike ʻia me ka hoʻopaʻa ʻana i ka maʻi maʻi maʻi, ** hoʻopakele ke ola o ka pōpoki ke hiki ʻole ke kūʻai ʻana i ka hale maʻi**. No nā pōpoki e ālai pinepine, hoʻomāhuahua mau ka Perineal Urethrostomy (PU) i ka wehe ʻana.

Māhele 2: Luʻu hohonu: Feline Aortic Thromboembolism (FATE / "Saddle Thrombus")¶

He kakaikahi ka ulia pōpilikia i ka lāʻau lapaʻau holoholona e like me ka hikiwawe a weliweli e like me Feline Aortic Thromboembolism (FATE), i kapa ʻia he Saddle Thrombus. ʻO kahi pōpoki i ʻike ʻia he 100% olakino olakino ʻelima mau minuke ma mua, hoʻokuʻu koke ʻo ia i kahi ʻōpū ʻehaʻeha, hāʻule i kona ʻaoʻao me ka hāmama ʻana o ka waha, a kauo i nā wāwae hope ʻelua ma hope.

ʻO ka loulou huna ma waena o ka puʻuwai o ka pōpoki a me kona mau wāwae lolo¶

ʻAʻole like me nā ʻīlio, ʻaʻole hiki i nā pōpoki ke hoʻomohala koke i ka wāwae hope mai nā disc intervertebral paheʻe. Ma ** ma kahi o 85 a 90 pakeneka o nā pōpoki i nalowale koke i ka hoʻohana ʻana i nā wāwae hope ʻelua**, ʻo ke kumu he ** koko koko i hoʻokuʻu ʻia mai ka puʻuwai**.

1. Silent Hypertrophic Cardiomyopathy (HCM): Ma kahi o 15 pākēneka o nā pōpoki hale a pau (a hiki i ka 25 pakeneka o Maine Coons, Ragdolls, British Shorthairs, Sphynx, a me Peresia) lawe i ka ʻuhane Hypertrophic Cardiomyopathy, kahi e mānoanoa mālie ai ka pā ventricle hema i nā makahiki me ka ʻole o ka ʻōhumu ʻana o ka naʻau.
2. Ka Hoʻonui ʻana i ka Atrial Hema a me ka Hoʻokumu ʻia ʻana o Clot: Hoʻihoʻi ke koko i ke keʻena hema ma luna (atrium hema), e kīkoʻo ākea a hoʻokuʻu ʻia ke koko fibrous (thrombus) e hana.
3. **Embolization i ka "Saddle" o ka Aorta: ** Ua hemo kekahi ʻāpana o ia ʻāʻī, e ʻoki i lalo i ka aorta iho, a ma hope o ka ʻōpū kahi i ʻoki ai ke aorta (ka aortic trifurcation) i loko o nā aʻa iliac e hoʻolako ana i nā wāwae hope ʻelua.
4. Vasoconstriction a me Ischemic Neuropathy: Hoʻokuʻu ʻia nā platelets i loko o ka clot hou serotonin a me thromboxane A2, e hoʻopaʻa ai i nā moku pelvic collateral a pōloli i nā ʻiʻo wāwae a me nā aʻalolo sciatic o ka oxygen.

ʻO ka "5 P's" o ka Feline Saddle Thrombus Diagnosis¶

Hiki iā ʻoe ke ʻike i kahi Saddle Thrombus i manaʻo ʻia i loko o 30 kekona ma ka nānā ʻana i ka "5 P's" o Acute Arterial Thromboembolism:

1. Eha: Uwē, ʻuwē, ʻūhā, a ʻūhū ka pōpoki me ka puka ʻana o kona alelo mai ka ʻeha ʻeha a me ka wai hoʻokahi i loko o ka māmā (congestive heart failure).
2. Paralysis a Paresis: Hoʻokahi wāwae (20 pākēneka o nā hihia) a i ʻole nā ​​wāwae hope ʻelua (80 pākēneka o nā hihia) e kauo ʻia ma hope o ka pōpoki. ʻO nā ʻiʻo o ka wāwae haʻahaʻa ma lalo o ke kuli e lilo i pōhaku paʻakikī mai ka ʻaelike ischemic, a ʻaʻole hiki i ka kuʻekuʻe wāwae (hock) ke wili.
3. Pulseless: ʻAʻole hiki ke ʻike ʻia ka puʻupuʻu femoral ma luna o loko o ka ʻūhā i loko o ka pōpoki.
4. Pallor a i ʻole Cyanosis: E hoʻohālikelike i nā pā wāwae hope me nā wāwae mua. I loko o ka popoki olakino a i ʻole ka pōkiʻi hōʻeha iwi kuamoʻo, he ʻulaʻula mahana ka mua a me ke kua. I loko o kahi pōpoki Saddle Thrombus, he keʻokeʻo keʻokeʻo keʻokeʻo, hina, a i ʻole polū ʻeleʻele nā ​​ʻūhā hope a me nā moena nail.
5. Poikilothermia (Ice-Cold Paws): Hoʻopili i kekahi lima i ka wāwae mua a ʻo kekahi i ka wāwae hope; ʻO nā wāwae hope ma lalo o ke kuli ke ʻike ʻia ke anu i loko o 15 a 30 mau minuke.

ʻO ke kōkua mua a me nā lula halihali no Saddle Thrombus¶

• ** ʻO kēlā me kēia minuke me ka ʻole o ka opioid analgesia he mea ʻehaʻeha:** ʻO ka lawe ʻana i ka pōpoki i kahi kauka lapaʻau pilikia 24-hola i loko o 15 a 30 mau minuke no ka **methadone, fentanyl, a i ʻole hydromorphone i loko o ka intravenous ** ʻo ia ka mea nui o ka lāʻau lapaʻau.
• ** ʻAʻole loa e hoʻopili i nā pā mehana a i ʻole ka wai mahana i nā wāwae hope anu:** ʻO ka ʻiʻo mehana me ka hāʻawi ʻana i ke koko ʻaʻohe e hoʻolalelale i ka metabolism kelepona inā ʻaʻole hiki i ka oxygen ke komo i nā cell, e make ai nā ʻiʻo wāwae ʻekolu manawa wikiwiki. E mālama i ka pōpoki ma kahi mahana wela ma kahi kāwele maloʻo.
• ** MAI lomilomi a wili paha i nā wāwae hope ʻokiʻoki:** ʻO ka lomilomi ʻana i nā ʻiʻo o ka bipi ischemic e haki ana i nā ʻiʻo o ka ʻiʻo, e hoʻokuʻu ana i ka myoglobin a me ka potassium make i loko o ke kahe koko.
• E noho mālie a kū pololei i ka pōpoki i loko o kahi mea lawe ukana nui: Ma kahi o 40 a 50 pakeneka o nā pōpoki me ka Saddle Thrombus i ka manawa like e hoʻomohala ai i ka maʻi Congestive Heart Failure (pulmonary edema). E noho mālie a maʻalili ke kaʻa i hiki i ka pōpoki ke hanu me ka ʻole.
• ** Ka hoʻomaopopo ʻana i ka wānana ma ka ER Vet:** ʻO nā pōpoki kahi ** hoʻokahi wale nō wāwae hope** i hoʻopilikia ʻia, a i ʻole nā pōpoki i mālama i ka neʻe ʻana o ka ʻūhā a me ka wela o ka ʻāʻī ma luna o 37.2 degere Celsius (98.9 degere Fahrenheit), loaʻa iā 50 a 70 pakeneka ka nui o ke ola e hoʻokuʻu ʻia me ka hoʻoponopono ʻana i ka ʻeha, nā mea hoʻoheheʻe koko a me nā lāʻau lapaʻau (**clorobanrel a me nā lāʻau lapaʻau) ho'ōla hou i ka hana hele wāwae ma luna o 2 a 6 mau pule. ʻO nā pōpoki me nā wāwae hope ʻelua i lolo, nā keiki bipi paʻa pōhaku, ka puʻuwai, a me kahi wela haʻahaʻa haʻahaʻa ma lalo o 36.5 degere Celsius (97.7 degere Fahrenheit) ke kū nei i kahi wānana ʻoi aku ka koʻikoʻi (25 a 35 pakeneka ke ola), a ʻo ka euthanasia kanaka ma hope o ka hoʻomaha ʻana i ka ʻeha he koho aloha inā ʻaʻole hiki ke mālama ʻia ka ʻeha.

Māhele 3: Luʻu hohonu: Acute Canine a me Feline Spinal Paralysis (IVDD a me FCE)¶

Ke haalulu koke ka ilio (a i ole popoki paha) ma na wawae hope, kukuli ma ka piko o kona mau wawae, uwau ke hoopa ia kona ai a i ole ke kua, a kauo paha i kona hope ** oiai e mahana ana a me ka poni kona mau kua, he neurological ka pilikia: Acute Spinal Cord Compression or Infarction.

ʻO nā kumu nui ʻelua o ka lolo hope o ka ʻīlio¶

1. ** ʻO ka maʻi disc intervertebral (IVDD, Hansen Type I a me Type II):** Aia ma waena o kēlā me kēia iwi iwi he ʻūhā hoʻohāhā i kapa ʻia he disiki intervertebral, i kūkulu ʻia me kahi apo fibrous waho (annulus fibrosus) e hoʻopuni ana i kahi kikowaena palupalu (nucleus pulposus).
2. Hansen Type I Disc Extrusion: Ma ** chondrodystrophic (pōkole-wāwae) ʻano ** e like me **Dachshunds (20 a 25 pakeneka o ka pilikia o ke ola), French Bulldogs, Welsh Corgis, Beagles, Shih Tzus, Pekingese, Lhasa Apsos, Basset Hounds, a me Cocker Spaniels i loko o ka minerala ma mua o ka minerala. a hiki i ka 2 makahiki. I ka neʻe ʻana maʻamau (lele mai kahi moena a haʻalulu paha), ua kulu ke apo o waho a me nā mea disiki i hoʻopaʻa ʻia e lele i luna i loko o ke awāwa iwi kuamoʻo, e ʻeha a ʻeha ka iwi kuamoʻo.
3. Hansen Type II Disc Protrusion: I nā ʻano nui (German Shepherds, Labrador Retrievers, Dobermans, Rottweilers) mai ka 5 a hiki i ka 12 makahiki, ʻoi aku ka nui o ke apo fibrous o waho ma mua o ka ulu ʻana i ka lolo.
4. Fibrocartilaginous Embolism (FCE, "Spinal Stroke"): Mea maʻamau i loko o nā ʻano ʻano waena-a-pilikia (Miniature Schnauzers, Boxers, Labradors, Great Danes, Irish Wolfhounds). I ka lele ʻana a i ʻole ka holo ʻana, komo kahi ʻāpana microscopic o ka cartilage disc maʻamau i kekahi o nā aʻa liʻiliʻi e hānai ana i ke kuamoʻo, e hoʻoulu ai i ka ʻeha ischemic ʻeha ma kēlā ʻaoʻao kuamoʻo. ʻO nā ʻīlio me ka FCE maʻamau ** uē i hoʻokahi manawa i ka wā hoʻoikaika kino, hāʻule koke me ka maʻi maʻi asymmetric (ʻoi aku ka nāwaliwali o kekahi wāwae hope ma mua o kekahi), loaʻa ʻo ZERO ʻeha o ke kuamoʻo ma hope o nā minuke mua**, a hoʻōla hou ma o ka hoʻoponopono kino ʻana me ke ʻoki ʻole.

ʻO ka 5-Grade Veterinary Neurological Scale no IVDD (A me ka "Deep Pain" Clock)¶

Hoʻokaʻawale ka poʻe neurologist lāʻau i ka ʻeha spinal cord i Papa 1 a hiki i 5 no ka hoʻoholo ʻana inā hiki i ka hoʻomaha crate koʻikoʻi ke hoʻōla i ka iwi kuamoʻo a i ʻole ke koi ʻia ʻo neurosurgery pilikia (hemilaminectomy) i loko o nā hola:

ʻO ka hoʻopaʻa ʻana i kēlā me kēia ʻanuʻu a me ka lawe ʻana i ka zero-flexion no ka ʻīlio lolo a i ʻole ka pōpoki¶

I ka wā i pohā hapa ʻia ai kekahi diski intervertebral (Papa 1, 2, a i ʻole 3), e noho pono ana nā mea disiki calcified hou ma ka waimaka e kali ana e ʻoki ʻia i luna i loko o ke kuamoʻo. ** ʻO kēlā me kēia ʻanuʻu a kāu ʻīlio e hele ai ma ka papahele, a i ʻole i kēlā me kēia manawa e hāʻule ana ko lākou iwi kuamoʻo i ka wā e ʻohi ʻia ai ma lalo o nā ʻāʻī, e ʻomi i nā mea disiki pohihihi hou aʻe i loko o ke kuamoʻo, e hoʻohuli ai i ka wīwī Papa 2 hiki ke hoʻohuli ʻia i loko o ka maʻi maʻi pae 5 hiki ʻole ke hoʻihoʻi ʻia.**

1. Hooki i ka neʻe ʻana a pau ma kahi e kū ai ka ʻīlio a e moe ana: Mai kāhea aku i ka ʻīlio e hele mai iā ʻoe e "hoʻāʻo" inā hiki iā ia ke hele. E hele wāwae i ka ʻīlio.
2. E hoʻomākaukau i kahi pahu lawe paʻa paʻa ma ka ʻaoʻao o ka ʻīlio: No nā ʻīlio liʻiliʻi a me ka liʻiliʻi ma lalo o 15 kilokani (33 paona) a me nā pōpoki, e lawe mai i kahi mea lawe kaʻa kaʻa paʻa paʻa a i ʻole kahi hīnaʻi holoi lole ʻiʻo paʻa i hoʻopaʻa ʻia me kahi kāwele pelu. No nā ʻīlio nui ma luna o 20 kilokani (44 paona), e hoʻohana i kahi ʻāpana lāʻau palahalaha, kahi papa kīʻaha, a i ʻole kahi pākeʻe koʻikoʻi i hoʻopaʻa ʻia ma 6 mau wahi e nā kānaka ʻelua.
3. E hoʻokō i ka "Two-Arm Horizontal Log-Roll Lift": Mai koho i kahi ʻīlio i manaʻo ʻia ʻo IVDD ma lalo o nā ʻāʻī mua me ke kau ʻana o ka hope. E kukuli ma ka ʻaoʻao o ka ʻīlio, e hoʻoheheʻe ** hoʻokahi lima lima ma lalo o ka umauma i mua o nā wāwae mua**, a e hoʻoheheʻe i kou ** lima ʻē aʻe ma lalo o ke pelvis ma hope o nā wāwae hope ** i noho ka iwi kuamoʻo i 100 pakeneka pae a me ka pae. E hoʻohaʻahaʻa pololei i ka ʻīlio i lalo i loko o ka pahu padded a hoʻopaʻa i nā kāwele i ʻōwili ʻia a puni nā ʻaoʻao e pale i ka paheʻe ʻana i ka wā e hoʻopaʻa ai.
4. ** ʻAʻole hāʻawi i kekahi mea ma ka waha ma mua o ka ʻoki ʻana:** Mai hāʻawi i ka meaʻai, ka mālama ʻana, ka wai, a i ʻole nā ​​lāʻau lapaʻau ma ke ala e hele ai i ka haukapila i hiki ai i ka ʻīlio ke komo palekana i ka maʻi maʻi āpau āpau no ka MRI/CT scan a me ke ʻoki hemilaminectomy.

ʻO ka mālama home a me ka pale hou ʻana ma hope o ka hoʻokuʻu ʻana i ka haukapila¶

• No nā "Piki Paʻa" ma hope o ka hoʻopaʻa ʻana (Kaohi ʻana i ka hoʻopaʻa hou ʻana): E nānā i ka nui o ka puʻupuʻu mimi i kēlā me kēia 4 hola no nā lā 7 mua. He mea maʻamau ka hele ʻana i nā puʻupuʻu ping-pong-ball liʻiliʻi a i ʻole ka mimi ʻulaʻula ʻulaʻula no 2 a 3 mau lā ma hope o ka wehe ʻana i ka catheter he mea maʻamau ia, akā inā ʻoki ka pōpoki a hoʻohua ʻole i nā kulu o ka mimi, e hoʻi koke i ka ER vet (hiki ke keakea hou i 15 a 35 pakeneka o nā pōpoki i loko o ka pule mua). Hāʻawi i kēlā me kēia ʻano o nā mea hoʻomaha hoʻomaha urethral i kauoha ʻia a me nā lāʻau ʻeha, a e hoʻololi mau i ka 100 pākēneka o ka ʻai ʻana me ka wai me nā punawai i hoʻoheheʻe ʻia ka mimi.
• No IVDD Spinal Dogs on Strict Crate Rest (The 4-to-6-Week Protocol): "Strict Crate Rest" 'o ia hoʻi he 23.5 mau hola i kēlā lā i kēia lā i loko o kahi pā liʻiliʻi no 4 a 6 mau pule piha a ʻo ke apo o waho o ka disverse intervertebral ka ʻōpala. E hali i ka ʻīlio ma waho no ka haʻihaʻi ʻana o ka lumi lumi liʻiliʻi he 5 mau minuke, e kākoʻo ana i ko lākou ʻōpū me ka maʻa hope a i ʻole ke kāwele ʻauʻau i ʻōwili ʻia, a laila e hoʻihoʻi pololei iā lākou i loko o ka pahu me ka hele ʻole ʻana o ke kaula, ʻaʻohe mea e komo ai, a me nā alapiʻi ʻole.

Nīnau pinepine¶

Nānā ʻia nā kumu¶

• ** American College of Veterinary Internal Medicine (ACVIM) & American College of Veterinary Emergency and Critical Care (ACVECC) (United States / International):** *Consensus Statements on Diagnosis and Management of Acute Canine Thoracolumbar Intervertebral Disc Extrusion (IVDD), Feline Cardiomyopathies, and Feline Aortic Thromboembolism (FATE Aortic Thromboembolism).
• ** Ke Kula Nui o Cornell University of Veterinary Medicine, Cornell Feline Health Center (United States):** Feline Lower Urinary Tract Disease (FLUTD), Urethral Obstruction Hyperkalemia Triage, a me Hypertrophic Cardiomyopathy (HCM) Guidelines.
• International Society of Feline Medicine (ISFM) & American Association of Feline Practitioners (AAFP) (United Kingdom / United States): ISFM Consensus Guidelines on the Management of Urethral Obstruction in Cats and Feline Idiopathic Cystitis.
• Royal Veterinary College (RVC) Neurology and Neurosurgery Service (United Kingdom): Clinical Grading of Canine Spinal Cord Injury (Grades 1 to 5), Nociception Testing, and Conservative vs. Surgical Hemilaminectomy Outcomes.

Nā alakaʻi pili¶

• ʻO ka puʻu ʻīlio (GDV), ka wela o ka ʻīlio, a me nā pilikia ulia holoholona
• ʻO ka ʻīlio a i ʻole ka pōpoki: manuver Heimlich holoholona a me CPR holoholona
• ʻAi holoholona a me ka ʻai ʻana i nā mea ʻawaʻawa
• ʻO nā pilikia hana ʻīlio a pōpoki paha (dystocia) a me ka hoʻōla hou ʻana o nā pēpē hou
• Nā holoholona i nā pilikia a me nā haʻalele
• Nā helu pilikia ma ka ʻāina